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Nephrology MOC Sample Question 1

A 55-year-old man is recently diagnosed with multiple myeloma. He is admitted to hospital with a fever. He has no other complaints. Blood pressure and physical exam are normal including the absence of peripheral edema. His serum sodium concentration returns as 128 mEq/L. Other electrolytes including renal function are normal. Serum osmolality is 292 mOsm/L. What further testing is most likely to confirm what is causing the hyponatremia?

  • AMeasuring urine Osmolality
  • BAsking the chemistry lab to measure serum sodium concentration using direct potentiometry
  • CMeasuring serum glucose concentration
  • DMeasuring serum ADH levels

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